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Why Do Falls and Lower Limb Fractures Occur More Frequently in the Diabetic Patient and How Can They Be Prevented?
Diabetes Ther. 2020 Aug; 11(8):1687-1694.DT

Abstract

Due to primarily sarcopenia and hypoglycemia but also neuropathy, hypotension, analgesics and polypharmacy, there is an increased incidence of falls and hip fractures in both the type 1 and type 2 diabetic patient. Utilization of insulin, hypotensive drugs, analgesics and perhaps canagliflozin further increases the risk. Thiazolidinedione use may increase the risk of osteoporosis and fracture. Prolonged hyperglycemia resulting in cross-linking of collagen and advanced glycosylation end products alter the microarchitecture and increase bone fragility. Higher serum vitamin D levels seem to decrease the incidence of both falls and fractures. Following a hip fracture, mortality in the diabetic patient is increased largely because of cardiovascular events and pneumonia. Prevention of sarcopenia includes dietary therapy, vitamin D and testosterone replacement when appropriate.

Authors+Show Affiliations

Southside Endocrinology and Diabetes and Thyroid Associates, Birmingham, AL, USA. dshbell@yahoo.com.Southside Endocrinology and Diabetes and Thyroid Associates, Birmingham, AL, USA.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32651838

Citation

Bell, David S H., and Edison Goncalves. "Why Do Falls and Lower Limb Fractures Occur More Frequently in the Diabetic Patient and How Can They Be Prevented?" Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders, vol. 11, no. 8, 2020, pp. 1687-1694.
Bell DSH, Goncalves E. Why Do Falls and Lower Limb Fractures Occur More Frequently in the Diabetic Patient and How Can They Be Prevented? Diabetes Ther. 2020;11(8):1687-1694.
Bell, D. S. H., & Goncalves, E. (2020). Why Do Falls and Lower Limb Fractures Occur More Frequently in the Diabetic Patient and How Can They Be Prevented? Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders, 11(8), 1687-1694. https://doi.org/10.1007/s13300-020-00877-z
Bell DSH, Goncalves E. Why Do Falls and Lower Limb Fractures Occur More Frequently in the Diabetic Patient and How Can They Be Prevented. Diabetes Ther. 2020;11(8):1687-1694. PubMed PMID: 32651838.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Why Do Falls and Lower Limb Fractures Occur More Frequently in the Diabetic Patient and How Can They Be Prevented? AU - Bell,David S H, AU - Goncalves,Edison, Y1 - 2020/07/10/ PY - 2020/06/03/received PY - 2020/7/12/pubmed PY - 2020/7/12/medline PY - 2020/7/12/entrez KW - Aging KW - Diabetes KW - Falls KW - Fractures KW - Hypoglycemia KW - Neuropathy KW - Osteoporosis KW - Polypharmacy KW - Sarcopenia SP - 1687 EP - 1694 JF - Diabetes therapy : research, treatment and education of diabetes and related disorders JO - Diabetes Ther VL - 11 IS - 8 N2 - Due to primarily sarcopenia and hypoglycemia but also neuropathy, hypotension, analgesics and polypharmacy, there is an increased incidence of falls and hip fractures in both the type 1 and type 2 diabetic patient. Utilization of insulin, hypotensive drugs, analgesics and perhaps canagliflozin further increases the risk. Thiazolidinedione use may increase the risk of osteoporosis and fracture. Prolonged hyperglycemia resulting in cross-linking of collagen and advanced glycosylation end products alter the microarchitecture and increase bone fragility. Higher serum vitamin D levels seem to decrease the incidence of both falls and fractures. Following a hip fracture, mortality in the diabetic patient is increased largely because of cardiovascular events and pneumonia. Prevention of sarcopenia includes dietary therapy, vitamin D and testosterone replacement when appropriate. SN - 1869-6953 UR - https://www.unboundmedicine.com/medline/citation/32651838/Why_Do_Falls_and_Lower_Limb_Fractures_Occur_More_Frequently_in_the_Diabetic_Patient_and_How_Can_They_Be_Prevented L2 - https://dx.doi.org/10.1007/s13300-020-00877-z DB - PRIME DP - Unbound Medicine ER -
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